More Than a Chip on Your Shoulder

Shoulder injuries are common for veterans and nonveterans alike. Between 7-8 million people see a doctor each year for shoulder pain and issues. There are 400,000-500,000 rotator cuff surgeries performed each year in the US alone, with expectation for that number to continue climbing. Why are there so many shoulder injuries? Shoulders can easily become injured from excessive or repetitive movements, mainly movements causing overhead lifting of the arms. Most shoulder injuries do not involve bone, but are of the ligaments, muscles and tendons.

Service-Connection & Ratings for Shoulder Injuries  

Repetitive training, lifting, heavy movements are part of the routine and day-to-day for both combat and noncombat veterans, so shoulder injuries happen often for both groups. Oftentimes, shoulder pain becomes “normal” and veterans don’t seek care for it. 

There are many different shoulder injuries. Some of them include:

  • Shoulder dislocation– this happens when the top part of your arm bone pops out of the socket in the shoulder
  • Rotator Cuff Tear– the rotator cuff is a group of four muscles that come together to form tendons covering the head of the humerus bone. The rotator cuff attaches your humerus bone to your shoulder blade and is what allows you to raise and lower your arms.
  • Separation– a shoulder separation occurs when ligaments between the shoulder blade and collarbone are torn
  • Tendonitis or Bursitis shoulder tendonitis is when the rotator cuff and bicep tendons become inflamed. Shoulder bursitis is when inflammation occurs in the subacromial bursa, which is the pad that cushions tissues and bones in between the shoulder blade and rotator cuff.
  • Replacement– when a shoulder is very damaged, due to severe trauma or severe arthritis, a replacement is sometimes necessary to remove the damaged areas and rebuild with metal or plastic implants
  • Amputation– shoulder amputations are rare. There are separate codes and ratings if this is a reality.

The following criteria must be met before the VA will establish service-connection and determine a disability rating. 

  1. Veteran must have a current and diagnosed shoulder condition
  2. Events, illness, injury, etc must have occurred during service that have caused or worsened the shoulder pain or condition
  3. A medical nexus must be provided to connect the condition to the in-service event, illness or injury

Once those criteria are met, the VA will establish a rating based on the severity of the condition. 

Words to know:

*Flexion- raising your arm directly in front of your body to over your head, if in full range of motion

*Abduction- raising your arm out to the side of your body

*Guarding- avoiding movements that would hurt

Ratings for limitation of arm movement-flexion or abduction, and dislocation

The VA rates shoulder injuries and conditions under both 38 CFR § 4.71a – Schedule of Ratings – Musculoskeletal System and § 4.73, Schedule of Ratings – Muscle Injuries.

Ratings for limitation of arm movement away from the body- flexion or abduction; Diagnostic code 5201


Dominant Hand


Non-Dominant Hand

Flexion OR Abduction During a Flare
40% 30% 0-25 degrees
30% 20% 30-45 degrees
20% 20% 90 degrees


Ratings for Dislocation; Diagnostic code 5202


Dominant Hand


Non-Dominant Hand

Frequency of Dislocations
30% 20% Frequent episodes & guarding of all arm movements
20% 20% Infrequent episodes & guarding of movement                                                          only at shoulder level

If you are experiencing shoulder or arm pain, don’t suffer in silence. Shoulder pain may feel like a regular part of your day to day, but it can get worse if left untreated. It’s important that you see a medical professional and find out what your options are.

Our team can help ensure you are receiving the most accurate ratings and disability compensation that you have earned and deserve. Connect with one of our team members for a free consultation here

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